Death comes to each of us. More and more, Americans reach the end of their lives in institutions. As the cost of nursing escalates, facilities that care for the dying increasingly turn to less expensive, and often untrained, nurses' aides (NAs) to provide for the needs of the dying. Quality end-of-life care represents an urgent national priority. Rural America contains not just a disproportionate share of the nation's elderly but also a higher age adjusted rate of mortality at every stage of life. Rural communities also possess unique cultural attributes that shape the experience of health care at the end of life. Toborg Associates proposes to develop a computer-based training (CBT) to train rural NAs in end-of-life care. Using focus groups and key informant interviews, staff will define the perceptions and attitudes of NAs in rural communities to issues related to the terminally ill and care at the end-of-life. They will develop a prototype web based CBT module to train NAs in end-of-life care for the terminally ill and conduct a feasibility test of the prototype module with up to 5 groups of a total of 50 rural NA who work with the terminally ill. Toborg Associates will describe in a monograph the findings and the potential of the approach to develop a CBT training program on end-of-life concerns for NAs in rural communities.